Improving the cost, quality, and safety of perioperative care: A systematic review of the literature on implementation of the perioperative surgical home

Cline, Kayla M.; Clement, Viviane; Rock-Klotz, Jennifer; Kash, Bita A.; Steel, Christopher A.; Miller, Thomas R.

doi:10.1016/j.jclinane.2020.109760

Cited by 21 publications

(21 citation statements)

References 33 publications

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“…It may be difficult to demonstrate the cost‐effectiveness of any form of perioperative home within hospital systems. There is limited evidence of direct cost reduction with adult perioperative surgical home implementation, although this may be due to the lack of analysis of the individual cost of care per episode 17 . Previous studies have shown significant cost reduction ($169 per episode) in adult patients undergoing total hip or knee arthroplasty 18 .…”

Section: Discussionmentioning

confidence: 99%

“…There is limited evidence of direct cost reduction with adult perioperative surgical home implementation, although this may be due to the lack of analysis of the individual cost of care per episode. 17 Previous studies have shown significant cost reduction ($169 per episode) in adult patients undergoing total hip or knee arthroplasty. 18 As healthcare institutions move toward bundled payment models for procedures, they are more likely to benefit from perioperative surgical home programs as they reduce ICU utilization and overall length of stay.…”

Section: F I G U R E 3 Same Day Case Cancellations For Pediatric Cases Requiring Anesthesia By (A) Cancellation Reason and (B) Age Groupmentioning

confidence: 99%

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The virtual pediatric perioperative home, experience at a major metropolitan safety net hospital

Conley

Facchin

et al. 2021

Pediatric Anesthesia

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Introduction: Successes from anesthesiologist-led perioperative surgical homes in the adult patient population have inspired similar initiatives by pediatric hospitals. Typically the care coordination for these perioperative homes is run through hospital-funded, on-site, preanesthesia clinics. Preliminary data from pediatric perioperative homes have shown promising results in improved patient outcomes and decreased length of hospital stay. The majority of pediatric surgeries within the country are performed in nonpediatric hospitals. Such centers may not have the infrastructure or financial resources for a freestanding pediatric preanesthesia clinic. Faced with this situation at the largest safety net hospital in New England, the authors present their experience designing and implementing a "Virtual Pediatric Perioperative Home," a telemedicine-based triage and preanesthetic optimization for pediatric patients at Boston Medical Center, Boston, MA. Methods:A retrospective chart review of all pediatric anesthesia cases at Boston Medical Center from February 1, 2019, to January 31, 2020, as well as the number of pediatric cases canceled or postponed on the day of surgery for any reason during the same time period was conducted.

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Section: Discussionmentioning

confidence: 99%

Section: F I G U R E 3 Same Day Case Cancellations For Pediatric Cases Requiring Anesthesia By (A) Cancellation Reason and (B) Age Groupmentioning

confidence: 99%

The virtual pediatric perioperative home, experience at a major metropolitan safety net hospital

Conley

Facchin

et al. 2021

Pediatric Anesthesia

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“…According to Chan and Chan, [69], the success factors for the project include the safety, functionality, budget, cost, schedule, and quality of the project. The project success was measured [70] through cost, quality, safety [71], schedule, and the customer satisfaction. Project manager's leadership style and skills, coordination with project team members and project manager, availability of the financial resource, client's satisfaction, and project completion on time are very significant factors for project success [10,18,32,57,72,73].…”

Section: Literature Reviewmentioning

confidence: 99%

A Review on Key Performance Indicators for Measuring Real Estate Project Success

Rani¹,

Singh²,

Taneja³

et al. 2021

IJSDP

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The purpose of this study is to find numerous key performance indicators for measuring real estate project success. A Systematic literature review was adopted to achieve the research objective. The main objective of a systematic literature review is to identify, evaluate, and synthesize existing research. A total number of "82" papers from ABDC journals and other journals and conference papers, including thesis, book chapters, were used to identify all the success factors. The study reveals that most of the previous studies have considered three-factor cost, quality, and time, but a few factors have taken other success factors such as budget, schedule, client satisfaction, project manager competence. So there is a dire need to explore additional determinants as the real estate project success is influenced by several other variables. After the systematic literature review there are many other performance indicators such as customer satisfaction, budget, manager qualification and schedule are becoming important for good performance of construction project. The findings of the study have numerous suggestions and these implications are not only for the educational area but also for the construction sector. The study provides a direction for construction organizations and the researcher's future studies.

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“…In 2010, the Center for Medicare and Medicaid Services (CMS) introduced the bundled payment to control healthcare cost, and the Perioperative Surgical Home (PSH) emerged as a solution to ensure quality outcomes within this new payment system (Glickman et al, 2018;. Since then, researchers have evaluated PSH in a variety of surgical care settings (Cline et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…The PSH is a patient-centered system developed by the American Society of Anesthesiologists to improve patient's surgical outcomes (Chaurasia et al, 2014). Compared to a traditional surgical system, the PSH is a coordinated interdisciplinary team encompassing all surgical care provided to patients from the preoperative phase (30 days before surgery) through the recovery phase (90 days after surgery) (Cline et al, 2020;Kain et al, 2014;Vetter et al, 2013) (Figure 1). This state-of-the-art coordinated care system helps clinicians concentrate on value-based care not volume (Chimento & Thomas, 2017).…”

Section: Introductionmentioning

confidence: 99%

A Rural Community Hospital’s Perioperative Surgical Home Model Compared to a Traditional Surgical System

Sridhar

Carnegie

Mouat-Hunter

et al. 2022

Proceedings of the International Symposium on Human Factors and

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Background: The Perioperative Surgical Home (PSH) was designed by the American Society of Anesthesiologists (ASA) to improve perioperative care through more coordinated and communicative decision-making. PSH has proven success in large urban health centers by reducing surgery cancellation, operating room time, length of stay (LOS), and readmission rates. Yet, only limited studies have assessed the impact of PSH on surgical outcomes in rural areas. Thus, this study compared surgical outcomes – LOS, discharge disposition, and 90-day readmission – at a rural hospital from cohorts before and after the implementation of PSH. Method: An initial model of a PSH system was initiated in a local rural hospital. This newly created clinical team and outpatient clinic retrospectively assessed total joint surgeries occurring from November 2017 to April 2018 (before PSH, n = 324) as well as from November 2018 to April 2019 (after PSH, n = 326). General linear models were used to understand the impact of PSH on rural surgical outcomes. Results: Implementing PSH had a positive impact on LOS (P-value < 0.01), discharge disposition (P-value < 0.01), and readmission (P-value = 0.03).Conclusion: Implementation of the PSH system in a rural, community hospital reduced LOS, 90-day readmission, and increased direct to home discharge. Increased clinical management standardization across internal and external stakeholders was achieved because the PSH clinic enabled a centralized navigation point for clinicians, patients, and their families to better communicate and coordinate care.

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Improving the cost, quality, and safety of perioperative care: A systematic review of the literature on implementation of the perioperative surgical home

Cited by 21 publications

References 33 publications

The virtual pediatric perioperative home, experience at a major metropolitan safety net hospital

The virtual pediatric perioperative home, experience at a major metropolitan safety net hospital

A Review on Key Performance Indicators for Measuring Real Estate Project Success

A Rural Community Hospital’s Perioperative Surgical Home Model Compared to a Traditional Surgical System

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